Indocyanine green selectively stains the internal limiting membrane

PURPOSE: To demonstrate whether indocyanine green stains the inner limiting membrane of the retina or residual vitreous cortex. METHODS: We report on the intraoperative staining patterns of the vitreomac ular interface in 10 eyes of 10 consecutive patients who underwent vitrecto my with indocyanine green staining for macular hole formation and diffuse d iabetic macular edema. RESULTS: In five eyes of five patients with macular holes, indocyanine gree n staining of the macula after posterior vitreous detachment resulted in an immediate visibility of a discernable membrane that was not previously see n. In five eyes of five patients with diffuse diabetic macular edema and ad herent cortical vitreous, indocyanine green failed to stain the vitreomacul ar interface. After peeling off the residual vitreous cortex, however, a di scernable membrane could be identified using indocyanine green dye again, L ight and transmission electron microscopy revealed the inner limiting membr ane as the membrane that had been stained and removed in all specimens. CONCLUSION: Indocyanine green selectively stains the inner limiting membran e. Staining of the vitreomacular interface using indocyanine green as a vit al dye enables the surgeon to distinguish between the residual vitreous cor tex and the inner limiting membrane, and it allows safer and easier removal of the inner limiting membrane. (Am J Ophthalmol 2001;131:387-388. (C) 200 1 by Elsevier Science Inc. All rights reserved.).